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Clin Drug Investig. 2018 Aug;38(8):785-794. doi: 10.1007/s40261-018-0675-8.
Patiromer (Veltassa) for oral suspension is a non-absorbed, sodium-free potassium binding polymer that exchanges calcium for potassium in the gastrointestinal (GI) tract, thereby increasing faecal potassium excretion and reducing serum potassium levels. Patiromer was approved in the USA in 2015 and is now approved in several other countries, including those of the EU, for the treatment of hyperkalaemia in adults. In clinical trials, patiromer reduced serum potassium levels and the risk of recurrent hyperkalaemia in patients with chronic kidney disease (CKD) and/or diabetic nephropathy with or without heart failure (HF), allowing the majority of patients to continue receiving renin-angiotensin-aldosterone system (RAAS) inhibitors (drugs that inhibit the renal excretion of potassium) for up to 52 weeks. Patiromer also maintained normokalaemia in patients with HF and a propensity for hyperkalaemia, enabling concomitant administration and up-titration of spironolactone. Patiromer was generally well tolerated, with a low risk of hypokalaemia. GI disorders and hypomagnesaemia were the most common adverse events; these were generally of mild or moderate severity. Therefore, oral patiromer is a valuable treatment option for the long-term management of hyperkalaemia.
聚磺苯乙烯钠（Veltassa）口服混悬剂是一种不被吸收的、无钠的钾结合聚合物，它在胃肠道（GI）中通过交换钙和钾，从而增加粪便中钾的排泄并降低血清钾水平。聚磺苯乙烯钠于 2015 年在美国获得批准，目前已在包括欧盟国家在内的其他几个国家获得批准，用于治疗成人高钾血症。在临床试验中，聚磺苯乙烯钠降低了慢性肾脏病（CKD）和/或合并心力衰竭（HF）或不合并 HF 的糖尿病肾病患者的血清钾水平和复发性高钾血症的风险，使大多数患者能够继续接受肾素-血管紧张素-醛固酮系统（RAAS）抑制剂（抑制肾脏排钾的药物）治疗长达 52 周。聚磺苯乙烯钠还维持了 HF 合并高钾血症倾向患者的血钾正常，使螺内酯能够同时给药和滴定剂量。聚磺苯乙烯钠总体上具有良好的耐受性，低钾血症风险低。胃肠道疾病和低镁血症是最常见的不良事件；这些不良事件通常为轻度或中度。因此，口服聚磺苯乙烯钠是长期管理高钾血症的有价值的治疗选择。
